Development of Educational Aids for the Parents of Children Having Colostomy R KALA I WALIA KLN RAo Aim  To develop the educational aids for parents of children having colostomy and test its effectiv
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Development of Educational Aids for the Parents of Children Having Colostomy R KALA I WALIA KLN RAo Aim To develop the educational aids for parents of children having colostomy and test its effectiv

Methods WO educational aids in the fm of booklet and a video film computer disk were developed and these were used to teach care of colostomy to parents n 120 of children having anorectal malformations or Hirschsprungs disease Ress It was found tha

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Development of Educational Aids for the Parents of Children Having Colostomy R KALA I WALIA KLN RAo Aim To develop the educational aids for parents of children having colostomy and test its effectiv




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Presentation on theme: "Development of Educational Aids for the Parents of Children Having Colostomy R KALA I WALIA KLN RAo Aim To develop the educational aids for parents of children having colostomy and test its effectiv"— Presentation transcript:


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Development of Educational Aids for the Parents of Children Having Colostomy R KAL~A* I WALIA* KLN RAo3 Aim : To develop the educational aids for parents of children having colostomy and test its effectiveness. Methods WO educational aids in the f&m of booklet and a video film (computer disk) were developed and these were used to teach care of colostomy to parents (n 120) of children having anorectal malformations or Hirschsprung’s disease. Res&s : It was found that the developed educational aids were effective in order to provide knowledge and skill to the parents (p 0‘05).

Concltrsions : There is a great need to develop the educational aids for parents, subsequently these can be used to teach procedures for long term home management of the children born with congenital anomalies. Key words Colostomy care, parent education, congenital anomalies, anorectal malformations, Hirschsprung’s disease. The care of the children with colostomy is the child needs to be provided all the care a complex, challenging and lengthy process, by the parents after discharge from the though colostomy in a child is often hospital. Subsequent to colostomy a large temporary. However,

since it alters the number of patients do not turn up for follow- external appearance of rhe child, the up trea‘tment in India. Probable reasons for psychological impact on the child and the this could be colostomy complications, family at times is profound. Sometimes the culminating in high infant mortality rate and attitudes .of the family strongly influence death due to diarrhea etc. Low socio- adjustment to surgery,’ Managing a child economic status of the parents of children, with such a deformity or caring for a child lack of knowledge regarding medical care having colostomy is not

institutionalized for and meager resources to meet the cost of economic and administrative reasons. Hence medical care are some of the impediments National Institute of Nursing Education ~14 Dr KLN Rao Dept of Pediatric Surgery Professor Head. Dept of Pediatric Surgery PGIMER, Chandigarh 160 012 PGIMER, Chandigarh 160 012 Clinical Instructor, Ph. 0172-2747585 Ext. 5326, 5320 Principal, National Inst of Nursing Education Fax : 0091-172-2744401, 2745078 Prof Head, Dept of Pediatric Surgery These patient educational aids are available from Sr author, Ernail : klnrao@hotnmil.com
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16 J INDIAN ASSOC PEDIATRSURG VOL9 (JAN-MAR2004) which probably compel the parents to delay consent. Later, the video shots were edited or postpone the follow-up visits, Such and these were supported with audio situations affect the management and have narration in Hindi. The duration of the film an impact on the prognosis of the child. The is 18 minutes. parents need to be provided ongoing education and support commencing from expert panel validated these educational pre-operative teaching to discharge from the aids. To assess the efficacy of the developed hospital and home care.* The nurses

can educational aids, the parents were exposed help the parents of such children by teaching to these. The sample constituted 3 groups (n them about the home care and proposed 40 each) using the booklet, video film, and combination of booklet and video film treatment protocols. Moreover they can direct the parents to appropriate resource for teaching to the parents, Pre-evaluation was conducted to assess the baseline agencies and provide the parents with guidance and support,3 nowledge of the parenTs, This is followed by the teaching intervention. Post-evaluation The present study was

undertaken to was conducted between 1-3 months of the develop the educational aids for parents of teaching. children having colostomy and testing their Results effectiveness. Material and Methods The study sample represents population from the northern states of India, comprising of 62% literate parents. They were mostly engaged in semiskilled occupations like labourers (41%)) farmers (23%)) shopkeepers (18%) and government employees (18%). Seventy percent parents reported monthly income below Rs. 3000/-. Improvement in the mean score in the post-evaluation was observed among the parents

following the teaching intervention with all the educational aids, The difference of mean values was statistically significant (p =C .05), indicating the efficacy of the developed Two educational aids i.e. a booklet and video film/computer disk (CD) were developed on the care of colostomy, after rcvicw of the relevant literature. An assessment of the parents (n = 60) was done whose children had colostomy, to know their practices for care of the colostomy of their child. The booklet was developed in languages English, Hindi and Punjabi comprising of 17 figures and 16 pages of text regarding the

colostomy, stoma, procedure of care of colostomy, application of colostomy bag on the stoma and complications of the coloston~y. A colttm~ on the last page is provided for the parents to keep a note of the educational aids (Table I). Discussion Educational aids assist the teacher to convey problems faced related to the care of the child, For developing the video film, the the message effectively. The message may be story line was developed and the sequences conveyed by expression, gestures, spoken or were planned and listed down. The shooting written symbols. Modern technology has was done in

original settings using the facilitated the availability of many types of children and parents after obtaining their educational aids. These are used as tools to assist active learning. The educational
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EDL’CATIONAL AIDS FOR PARENTS OF CHILDREN HAVING COLOSTOMY 17 Table I Difference of mean pre and post test scores of parents following education through booklet, video film and booklet + video film on the care of colostomy (Maximum Score 10) Pre-test Post-test P value 3.53 1.15 3.45 1.62 4.18 1.18 6.05 1.58 5.70 1.24 6.28 1.48 (-05 c-05 <.05 materials developed in accordance to

the Based on the available literature and after specific needs of the learner, help to convey due thought, educational aids in the form of the message effectively. a booklet and a video film were accordingly Use of educational aids for the parents of the planned and prepared on the subject for the children having colostomy is not common in study. Video films have been developed after India. The children born with ARM are selecting suitable visuals of the actual brought to the hospital soon after birth for patients and parents. Completed video has initial management and surgery is performed.

the special effects, music and commentary. Following discharge of the patients from the Garvin (1990,) describe managing the hospital, parents are left to manage them on colostomy by using an ostomy pouch. their own. There are no supportive home Borkowski ( 1998)2 also describe that care services available for the parents of the management of colostomy requires proper children having colostomy. The limited time pouching technique with an appropriate available with the doctors and nurses does appliance. Creams are used to prevent peri- not enable them to systematically explain stoma1 skin

excoriation. Pediatric size and teach the parents. In such situations, pouches/colostomy bags described by these educational aids can be helpful in getting the authors are not easily available in the Indian message across effectively as a medium. market. Adult size colostomy bags being sold In order to derive the best possible ways to in India cost in the range of Rs. 45-65 per develop educational aids on the above bag. Older children having colostomy at subject, the available literature was times use these bags because the amount of identified and systematically perused. The fetes is large.

The bag lasts for a day or two. different types of educational aids for If it is wet, then ir needs to be changed. This reaching parents are reported in the is not economically viable for the parents in literature. Urine drainage systems,’ cleft lip,> Indian situations. An effort was made to post-cardiac surgery6 and sleep disorders evolve a cost effective procedure for covering were studied. All these studies mentioned the stoma. The procedure used in the uscfclrncss of media resulting in present sttldy, comprises of covering the improvement of the knowledge and practices stoma with a coconut

oil carried out by the respondents. which is overlapped with
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18 J INDIAN ASSOC PEDIATR SURG VOL 9; {JAN-MAR 2004) dressing. Application of oily subsrance can (p *OS) . The educational aids developed in be in the form of coconut oil, siloderm the present study were found to be effective ointment, sarson oil, Vaseline etc, as these as an individual aid, as well as the materials are cheaper and readily available in combination of bookler and video film in the house or market. These oily substances terms of improvement of knowledge and reduce the cost of colostomy care to about

practices to be carried out by the parents. Rs. 100-150 per month. The aim of the present study was to assess Roe (1990)4 rested the effects of an the effectiveness of the educarional aids. The education programme including an results on the limited number of parents in information booklet on the indwelling this study have been found to be favorable urethral catheter. The booklet significantly and encouraging. The parents of the children influenced the Datients knowledee. suffering from colostomy not only felt relieved but also felt confident following the Significant change was observed in

the pre and post-test responses of the parents regarding knowledge and practices of care of colostomy following education through booklet: on care of colostomy. Greenberg et al (1999) evaluated the use of educational aids. The results of the present study generally support the previous studies reported from western countries that show similar effects on the outcomes of educational interventions irrestlective of the impact of an educational video film on the parental respdnses through a questionnaire on pain management of children and found that video film effectively increased the test scores.

Video films developed in the present srudy were found to be an effective mode of method of providing information. Conclusions Both the educational aids i.e, booklets and video films developed during the study were found to be effective in improving the knowledge and practices to be carried out by teaching as it improved the knowledge and the practices to be carried out for colostomy the parents. The booklet and the video film care. Irrespective of the literacy status of the can be used individually or in combination parents significant mean difference in pre to provide education to parents

about the and post-evaluation scores of parents was care of colostomy. Nurses and all health observed following education through video team members working in the Pediatric film. surgery department can make use of the educational aids for educating the parents The results of the study by Callaghan whose children had a colostomy. In the Chan (200 1) lo indicated that the videotape present study, the outcome improved among information had slightly better outcome but all the groups of parents who were given the results were not statistically significant. education using various types of

educational In the present study booklet with video film aids. Perhaps the method of presenting the on care of colostomy was used and found to information is less itnportant than the be significantly increase the mean pre-test content of the information and the ability of score of 4.18 to mean post-test score of 6.28. the learner to understand it. The me an difference was significant
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EDUCATIONAL AIDS FOR PARENTS OF CHILDREN HAVING COLOSTOMY 19 References Willis J. Growing up with a stoma. Nurs Times following cardiac surgery. J Pediatr Nurs 1995; 1998; 94:27-28. 10:48-57.

Borkowski S. Pediatric stomas, tubes and Murphy PW, Chesson AL, Walker L, et al. appliatlces. Pediatr Clin North Am 1998; Comparing the effectiveness of video and 45:1419-1435. written material for improving knowledge Dixon E, Park R. Do patients understand among sleep disorders clinics patients with written health information. Nurs Outlook limited literacy skills. South Med J 2000; 1990; 38:278-281. 93:297-304. Roe BH. Study of the effects of education on Gravin G. Caring for children with ostomies. patients’ knowledge and acceptance of their Nurs Clin North Am 1994; 29645-654. indwelling

urethral catheters. J Adv Nurs Greenberg RS, Billett C, Zahurak M, et al. 1990; 15:223-231. Video tape increases parental knowledge about pediatric pain management. Anesth Campbell C, Louw B. Guidance to parent of Analg 1999; 89:899-903. black babies with a cleft lip and palate. South Afr J Comm Disorders. 1992; 39:43-49. Callaghan Chan HC. The effecrs of videotaped or written information on Chinese Stinson J, Mckeever I? Mothers information gastroscopy patients’ clinical outcomes. needs related to caring for infants at home Patient Educ Couns 2001; 42:225-2230.